2. Paroxysmal stage
Coughs worsens – becomes rapid, successive, paroxysmal 3 to 10x during expiration with prolonged inspiratory phase.
Force of coughing may cause involuntary micturation/defacation
The whoop follows the end of a series of short explosive cough with no time to catch a bread between cough.
Protrusion of eyeballs, protruded tongue.
Swollen head & neck veins.
Abdominal hernia
Vomiting signals end attack.